Form W-2C Corrected Wage and Tax Statement

Attention:
This form is provided for informational purposes only. Copy A appears in red, similar
to the official IRS form. Do not file copy A downloaded from this website with the
SSA. The official printed version of this IRS form is scannable, but the online version
of it, printed from this website, is not. A penalty of $50 per information return may be
imposed for filing forms that cannot be scanned.
To order official IRS forms, call 1-800-TAX-FORM (1-800-829-3676) or Order
Information Returns and Employer Returns Online, and we’ll mail you the scannable
forms and other products.

You may file Forms W-2 and W-3 electronically on the SSA’s website at
Employer Reporting Instructions & Information. You can create fill-in versions of
Forms W-2 and W-3 for filing with SSA. You may also print out copies for filing
with state or local governments, distribution to your employees, and for your
records.
See IRS Publications 1141, 1167, 1179 and other IRS resources for information
about printing these tax forms.

Comp Specialist: This form needs to have a 2/3" head margin when the PDF is cropped.

DO NOT CUT, FOLD, OR STAPLE THIS FORM
For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructions
for Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
Correct information

i

Last name

Suff.

Employee’s address and ZIP code

Previously reported

Correct information

1

Wages, tips, other compensation

1

Wages, tips, other compensation

2

Federal income tax withheld

2

Federal income tax withheld

3

Social security wages

3

Social security wages

4

Social security tax withheld

4

Social security tax withheld

5

Medicare wages and tips

5

Medicare wages and tips

6

Medicare tax withheld

6

Medicare tax withheld

7

Social security tips

7

Social security tips

8

Allocated tips

8

Allocated tips

9

Advance EIC payment

9

Advance EIC payment

10

Nonqualified plans

12a See instructions for box 12

12a See instructions for box 12

C
o
d
e

C
o
d
e

12b

12b

C
o
d
e

C
o
d
e

12c

12c

C
o
d
e

C
o
d
e

12d

12d

C
o
d
e

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

13

14

Retirement
plan

Third-party
sick pay

Other (see instructions)

10

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

17 State income tax

17

State income tax

17

State income tax

17

State income tax

Locality Correction Information
Previously reported

Previously reported

Correct information

Correct information

18 Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

19 Local income tax

19

Local income tax

19

Local income tax

19

Local income tax

20 Locality name

20

Locality name

20

Locality name

20

Locality name

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Copy A—For Social Security Administration
Cat. No. 61437D

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructions
for Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
Correct information

i

Last name

Suff.

Employee’s address and ZIP code

Previously reported

Correct information

1

Wages, tips, other compensation

1

Wages, tips, other compensation

2

Federal income tax withheld

2

Federal income tax withheld

3

Social security wages

3

Social security wages

4

Social security tax withheld

4

Social security tax withheld

5

Medicare wages and tips

5

Medicare wages and tips

6

Medicare tax withheld

6

Medicare tax withheld

7

Social security tips

7

Social security tips

8

Allocated tips

8

Allocated tips

9

Advance EIC payment

9

Advance EIC payment

10

Nonqualified plans

12a See instructions for box 12

12a See instructions for box 12

C
o
d
e

C
o
d
e

12b

12b

C
o
d
e

C
o
d
e

12c

12c

C
o
d
e

C
o
d
e

12d

12d

C
o
d
e

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

13

14

Retirement
plan

Third-party
sick pay

Other (see instructions)

10

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

17 State income tax

17

State income tax

17

State income tax

17

State income tax

Locality Correction Information
Previously reported

Previously reported

Correct information

Correct information

18 Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

19 Local income tax

19

Local income tax

19

Local income tax

19

Local income tax

20 Locality name

20

Locality name

20

Locality name

20

Locality name

Copy 1—State, City, or Local Tax Department
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

Safe, accurate,
FAST! Use

OMB No. 1545-0008

c Tax year/Form corrected

a Employer’s name, address, and ZIP code

Visit the IRS website
at www.irs.gov.
d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructions
for Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
Correct information

i

Last name

Suff.

Employee’s address and ZIP code

Previously reported

Correct information

1

Wages, tips, other compensation

1

Wages, tips, other compensation

2

Federal income tax withheld

2

Federal income tax withheld

3

Social security wages

3

Social security wages

4

Social security tax withheld

4

Social security tax withheld

5

Medicare wages and tips

5

Medicare wages and tips

6

Medicare tax withheld

6

Medicare tax withheld

7

Social security tips

7

Social security tips

8

Allocated tips

8

Allocated tips

9

Advance EIC payment

9

Advance EIC payment

10

Nonqualified plans

12a See instructions for box 12

12a See instructions for box 12

C
o
d
e

C
o
d
e

12b

12b

C
o
d
e

C
o
d
e

12c

12c

C
o
d
e

C
o
d
e

12d

12d

C
o
d
e

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

13

14

Retirement
plan

Third-party
sick pay

Other (see instructions)

10

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

17 State income tax

17

State income tax

17

State income tax

17

State income tax

Locality Correction Information
Previously reported

Previously reported

Correct information

Correct information

18 Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

19 Local income tax

19

Local income tax

19

Local income tax

19

Local income tax

20 Locality name

20

Locality name

20

Locality name

20

Locality name

Copy B—To Be Filed with Employee’s FEDERAL Tax Return
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

Safe, accurate,
FAST! Use

OMB No. 1545-0008

Visit the IRS website
at www.irs.gov.

c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructions
for Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
Correct information

i

Last name

Suff.

Employee’s address and ZIP code

Previously reported

Correct information

1

Wages, tips, other compensation

1

Wages, tips, other compensation

2

Federal income tax withheld

2

Federal income tax withheld

3

Social security wages

3

Social security wages

4

Social security tax withheld

4

Social security tax withheld

5

Medicare wages and tips

5

Medicare wages and tips

6

Medicare tax withheld

6

Medicare tax withheld

7

Social security tips

7

Social security tips

8

Allocated tips

8

Allocated tips

9

Advance EIC payment

9

Advance EIC payment

10

Nonqualified plans

12a See instructions for box 12

12a See instructions for box 12

C
o
d
e

C
o
d
e

12b

12b

C
o
d
e

C
o
d
e

12c

12c

C
o
d
e

C
o
d
e

12d

12d

C
o
d
e

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

13

14

Retirement
plan

Third-party
sick pay

Other (see instructions)

10

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

17 State income tax

17

State income tax

17

State income tax

17

State income tax

Locality Correction Information
Previously reported

Previously reported

Correct information

Correct information

18 Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

19 Local income tax

19

Local income tax

19

Local income tax

19

Local income tax

20 Locality name

20

Locality name

20

Locality name

20

Locality name

Copy C—For EMPLOYEE’s RECORDS
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

Notice to Employee
This is a corrected Form W-2, Wage and Tax Statement,
(or Form W-2AS, W-2CM, W-2GU, W-2VI or W-2c) for
the tax year shown in box c. If you have filed an income
tax return for the year shown, you may have to file an
amended return. Compare amounts on this form with
those reported on your income tax return. If the
corrected amounts change your U.S. income tax, file
Form 1040X, Amended U.S. Individual Income Tax
Return, with Copy B of this Form W-2c to amend the
return you already filed.

If you have not filed your return for the year shown in
box c, attach Copy B of the original Form W-2 you
received from your employer and Copy B of this Form
W-2c to your return when you file it.
For more information, contact your nearest Internal
Revenue Service office. Employees in American Samoa,
Commonwealth of the Northern Mariana Islands, Guam,
or the U.S. Virgin Islands should contact their local
taxing authority for more information.

For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructions
for Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
Correct information

i

Last name

Suff.

Employee’s address and ZIP code

Previously reported

Correct information

1

Wages, tips, other compensation

1

Wages, tips, other compensation

2

Federal income tax withheld

2

Federal income tax withheld

3

Social security wages

3

Social security wages

4

Social security tax withheld

4

Social security tax withheld

5

Medicare wages and tips

5

Medicare wages and tips

6

Medicare tax withheld

6

Medicare tax withheld

7

Social security tips

7

Social security tips

8

Allocated tips

8

Allocated tips

9

Advance EIC payment

9

Advance EIC payment

10

Nonqualified plans

12a See instructions for box 12

12a See instructions for box 12

C
o
d
e

C
o
d
e

12b

12b

C
o
d
e

C
o
d
e

12c

12c

C
o
d
e

C
o
d
e

12d

12d

C
o
d
e

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

13

14

Retirement
plan

Third-party
sick pay

Other (see instructions)

10

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

17 State income tax

17

State income tax

17

State income tax

17

State income tax

Locality Correction Information
Previously reported

Previously reported

Correct information

Correct information

18 Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

19 Local income tax

19

Local income tax

19

Local income tax

19

Local income tax

20 Locality name

20

Locality name

20

Locality name

20

Locality name

Copy 2—To Be Filed with Employee’s State, City, or Local Income Tax Return
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructions
for Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
Correct information

i

Last name

Suff.

Employee’s address and ZIP code

Previously reported

Correct information

1

Wages, tips, other compensation

1

Wages, tips, other compensation

2

Federal income tax withheld

2

Federal income tax withheld

3

Social security wages

3

Social security wages

4

Social security tax withheld

4

Social security tax withheld

5

Medicare wages and tips

5

Medicare wages and tips

6

Medicare tax withheld

6

Medicare tax withheld

7

Social security tips

7

Social security tips

8

Allocated tips

8

Allocated tips

9

Advance EIC payment

9

Advance EIC payment

10

Nonqualified plans

12a See instructions for box 12

12a See instructions for box 12

C
o
d
e

C
o
d
e

12b

12b

C
o
d
e

C
o
d
e

12c

12c

C
o
d
e

C
o
d
e

12d

12d

C
o
d
e

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

13

14

Retirement
plan

Third-party
sick pay

Other (see instructions)

10

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

16

State wages, tips, etc.

17 State income tax

17

State income tax

17

State income tax

17

State income tax

Locality Correction Information
Previously reported

Previously reported

Correct information

Correct information

18 Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

18

Local wages, tips, etc.

19 Local income tax

19

Local income tax

19

Local income tax

19

Local income tax

20 Locality name

20

Locality name

20

Locality name

20

Locality name

Copy D—For Employer
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

Employers, Please Note:
Specific information needed to complete Form W-2c is
given in the separate Instructions for Forms W-2c and
W-3c. You can order those instructions and additional
forms by calling 1-800-TAX-FORM (1-800-829-3676).

You can also get forms and instructions from the IRS
website at www.irs.gov. Electronic filing of Form W-2c is
preferred. For information on how to file electronically,
go to the Social Security Administration website at
www.socialsecurity.gov/employer.